Acupressure for Acne and Breakouts

Acne is a common skin condition that causes pimples. MedlinePlus explains that it starts in the pores: each pore opens to a follicle that holds a hair and an oil gland. When oil and old skin cells block the pore, they form a plug. A plug with a white top is a whitehead, one with a dark top a blackhead. If bacteria get trapped in the plug, the body's immune system reacts and a red pimple forms. Acne deep in the skin can cause hard, painful cysts. It shows up most on the face and shoulders, and also on the back, chest, arms, legs and buttocks.

Acne is most common in teenagers and young adults, but anyone can get it, and it tends to run in families. No one knows exactly what causes it. MedlinePlus lists things that may trigger it:

• hormonal changes that make the skin oilier, around puberty, periods, pregnancy, birth control pills or stress;
• greasy or oily cosmetics and hair products;
• certain medicines, such as steroids, testosterone, estrogen and phenytoin, and some medicine-containing IUDs;
• heavy sweating and humidity;
• touching, resting on or rubbing the skin too much.

Two common beliefs don't hold up. Dirt doesn't cause blackheads or pimples, and research does not show that chocolate, nuts or greasy foods cause acne. Diets high in refined sugar or dairy may be linked to acne in some people, but that link is debated. Stress doesn't cause acne, but it can make it worse. The Acne page is the reference; this post explains the routine behind it.

Acne is not dangerous, but it can leave scars, and MedlinePlus notes that some people become very depressed when it isn't cared for. It advises contacting your health care provider if:

• self-care and over-the-counter products don't help after several months;
• your acne is very bad, for example with a lot of redness around the pimples, or cysts;
• your acne is getting worse;
• you get scars as your acne clears up;
• acne is causing you emotional stress.

A provider can usually tell acne by looking at your skin, and can prescribe stronger medicines and creams or suggest other options. Acne often responds well, though it can take 6 to 8 weeks to see a change, and it may still flare up now and then. If you take a medicine that can trigger acne, don't stop it without talking to your provider first. If low mood is part of it, see Low Mood and Depression, and when not to self-treat.

A 2015 Cochrane review of complementary therapies for acne (Cao and colleagues) found 35 trials with 3,227 people, testing herbal medicine, acupuncture, wet cupping, diet, bee venom and tea tree oil. None of them tested acupressure. Results for acupuncture, herbal medicine and wet cupping were inconsistent, and most trials had an unclear risk of bias. The authors concluded there is a lack of evidence to support acupuncture, herbal medicine or wet cupping for acne. Some people in the acupuncture trials had itching, redness or pain where the needles went in. The review searched up to January 2014.

So little high-quality research exists for acupressure and acne, and the points below are tradition, labelled as such: a calm few minutes alongside good skin care and, where needed, a provider's care, not a way to clear the skin.

Traditional use: in TCM, points such as LI-11, ST-36 and GV-14 are traditionally used for skin breakouts. Each point's page shows where to find it and when to skip it.

• Main points: LI-11 Pool at the Crook (Qū chí) at the outer end of the elbow crease, ST-36 Leg Three Miles (Zú sān lǐ) on the lower leg, and GV-14 Great Hammer (Dà zhuī) at the base of the neck.
• For acne that follows hormonal changes: SP-6 Three Yin Intersection (Sān yīn jiāo) above the inner ankle.
• For facial breakouts: ST-44 Inner Courtyard (Nèi tíng) on the foot.
• Also used: LI-4 Joining Valley (Hé gǔ) on the hand and BL-13 Lung Shu (Fèi shū) on the upper back.

The Acne routine takes about 10 minutes. The idea behind it: MedlinePlus advises keeping your hands off your face, because touching, rubbing and picking can trigger acne, spread infection and leave scars. So none of the points is on the face. They sit on the arms, legs, feet and the back of the neck, and you start with clean hands.

1. Wash your hands and clean your face gently before starting.
2. Sit comfortably and take 5 slow, deep breaths.
3. Press LI-11 firmly, 1 minute on each arm, with the elbow bent.
4. Press ST-36, 1 minute on each leg.
5. Press GV-14, 1 minute, in the hollow just below the large bump at the base of the neck, not on the bone.
6. For acne that follows hormonal changes: add SP-6, 1 minute on each leg.
7. For facial breakouts: press ST-44 lightly, 30 seconds on each foot.

Pressure should be firm enough to feel but never painful, and never deep or unrelenting.

Skip or ease off: don't press on a pimple, a cyst or irritated, broken or blistered skin, or on bruises or new scars. Acne is common on the upper back and shoulders, so check GV-14 and BL-13 first and skip them over a breakout. Don't press LI-4 or SP-6 during pregnancy. GV-14: stop if you get a headache or feel dizzy, and skip it after a neck injury, with neck instability or very high blood pressure. LI-11 after an elbow injury or surgery. ST-36 and SP-6 after leg surgery, and ST-36 with an injury or infection of the lower leg. ST-44 after foot surgery, or with an open wound or infection between the toes. LI-4 after hand surgery or injury. BL-13 after a chest or rib injury, or if you can't reach it without straining. If you have a bleeding or clotting disorder or low platelets, press more lightly and for less time, or ask your doctor first.

Skin care does most of the work. MedlinePlus suggests:

• cleaning your skin gently with a mild, nondrying soap, once or twice a day and after exercise, without scrubbing or washing over and over;
• removing all make-up, never leaving it on overnight, and choosing water-based or noncomedogenic products (tested not to clog pores in most people);
• shampooing daily if your hair is oily, and keeping hair off your face;
• not squeezing, scratching, picking or rubbing pimples, and not touching your face;
• avoiding tight headbands, caps and hats, and greasy creams.

A little sun may improve acne slightly, but a tan mostly hides it, and too much sun raises the risk of wrinkles and skin cancer. If these steps aren't enough, talk with your provider; MedlinePlus notes that acne often responds well to medical care.